乌司他丁治疗前后慢性阻塞性肺疾病患者外周血TLR4及血清TNF-α的变化及意义

Expression of toll-like receptor 4 on peripheral blood monocytes and serum level of TNF-α in patients with chronic obstructive pulmonary diseases treated by ulinastatin

目的:探讨乌司他丁治疗前后慢性阻塞性肺疾病(COPD)患者外周血单核细胞样受体4(TLR4)及血清肿瘤坏死因子-α(TNF-α)的表达变化及意义。方法:选取20例COPD患者为实验组和20例健康体检者作为对照组,收集患者乌司他丁治疗前后外周血分离单核细胞,RT-PCR方法检测外周血单核细胞TLR4mRNA的表达。同时,收集外周血血清,酶联免疫吸附(ELISA)法检测TNF-α。结果:实验组患者乌司他丁治疗前和治疗后外周血单核细胞TLR4 mRNA的表达明显高于对照组(P<0.05);TNF-α在乌司他丁治疗前和治疗后COPD患者血清中的表达明显高于对照组(P<0.05);治疗前COPD患者外周血单核细胞TLR4mRNA表达和血清TNF-α水平明显高于治疗后患者(P<0.05)。此外,TLR4 mRNA与TNF-α相关性分析显示呈正相关。结论:COPD患者TLR4 mRNA及TNF-α表达明显增加,可能与慢性肺疾病的炎症反应有关;乌司他丁可明显抑制COPD患者炎症反应。

Objective To investigate the effects of ulinastatin on the expression of toll-like receptor 4 （TLR4） on peripheral monocytes and on serum level of TNF-α in patients with chronic obstructive pulmonary diseases （COPD）. Methods Peripheral blood samples were collected from 20 patients with COPD and 20 healthy controls, in which monoeytes were isolated and RT-PCR method was used to detect the expression of TLR4 mRNA. Enzyme-linked immunosorbent assay （ELISA） was used to measure serum level of TNF-α. Results The expressions of TLR4 mRNA on monocytes and serum levels of TNF-α in COPD patients before and after ulinastatin treatment were significantly higher than those in healthy controls （P 〈 0.05）. Expression of TLR4 mRNA on monocytes and serum level of TNF-α were significantly decreased after ulinastatin treatment （P 〈 0.05）. The expression of TLR4 mRNA on monocytes was positively correlated with serum level of TNF--α. Conclusions Expression of TLR4 mRNA on monocytes and serum level of TNF-α were increased, and may be associated with chronic inflammation in COPD patients. Ulinastatin could obviously inhibit the inflammatory response in COPD patients.